Summaries of health policy coverage from major news organizations

Senate Majority Leader Harry Reid (D-Nev.) on Tuesday said he is willing to delay a vote on revised legislation (HR 3963) that would reauthorize and expand the State Children's Health Insurance Program to compromise further with House Republicans, with the hopes of obtaining a veto-proof majority in the House, The Hill reports (Raju/Kaplan, The Hill, 10/31).

The legislation -- which is similar to the bill vetoed by President Bush earlier this month -- would expand SCHIP to cover 10 million children and increase spending on the program to $35 billion over five years, funded with a 61-cent-per-pack increase in the federal cigarette tax. The bill would limit coverage to children in families with annual incomes below 300% of the federal poverty level. The House last week failed to pass the revised bill with a veto-proof majority (California Healthline, 10/30).

Reid said that Sen. Orrin Hatch (R-Utah) and Senate Finance Committee Chair Max Baucus (D-Mont.) asked him to delay the vote on the bill so that they could draft an amendment that might draw more House support. Hatch and Baucus, along with Senate Finance Committee ranking member Chuck Grassley (R-Iowa) and Sen. John Rockefeller (D-W.Va.), met Tuesday with House Minority Leader John Boehner (R-Ohio) and Minority Whip Roy Blunt (R-Mo.) to discuss possible concessions.

The meeting, which "paired the bill's authors and strongest supporters with the two men who had, until now, been its strongest opponents," did not result in a compromise on changes to the bill, but the lawmakers agreed to meet again, according to CQ Today. The additional discussions "will inevitably take more time," which is why Reid requested the delay, CQ Today reports.

Reid requested consent to alter the Senate's schedule so that the chamber would first discuss a farm policy overhaul bill, which is expected to take more than a week to finish (Wayne, CQ Today, 10/30).

However, Senate Minority Whip Trent Lott (R-Miss.) objected to Reid's request to delay a vote on the bill, noting that Reid had not discussed the delay with him or Senate Minority Leader Mitch McConnell (R-Ky.) (CQ Today, 10/30). Lott said Republicans want to retain their right to filibuster the bill (Wayne, CQ Today, 10/30).

Lott said, "We ought to continue trying to find a solution," adding, "Unfortunately, there has been no real consultation with the leadership on this side of the aisle by those conducting these negotiations, or with the White House" (CQ Today, 10/30).

An aide said that Republican leaders are willing to delay the vote until Thursday, but no further. If Reid uses his right as majority leader to delay the vote further, Lott said Senate Republicans might delay the vote into Thanksgiving week (Johnson, CongressDaily, 10/31).

If Reid and McConnell can agree to changes in the chamber's schedule, the cloture vote scheduled for 6:30 p.m. Wednesday will be delayed (CQ Today, 10/30).

Meeting Details

Baucus and Grassley are considering an amendment that would lower the maximum income eligibility level for the program below 300% of the poverty level, according to a source, CongressDaily reports. However, it is "unclear whether the changes would persuade House Republicans who have twice voted against the bill," according to CongressDaily.

Grassley said, "You never know. You just try." If an amendment is added to the Senate bill, the House will need to re-vote on the measure before it can be sent to the White House (Johnson/Bourge, CongressDaily, 10/30).

Rep. Diana DeGette (D-Colo.) said she expects that House Democratic leaders will request that Baucus and Grassley produce a list of names of House Republicans pledging to support an amended bill (Wayne, CQ Today, 10/30).

Bush on Tuesday told Republicans in a closed-door meeting that he will not support the SCHIP bill if it includes a cigarette tax increase, according to officials who attended the meeting, the AP/Houston Chronicle reports. The decision "virtually ensures a renewed veto struggle with" Congress, according to the AP/Chronicle.

According to the officials, who spoke on the condition of anonymity, Bush said he wanted budget director Jim Nussle to identify spending cuts that could pay for an expansion of the program. Bush said that if he signed the SCHIP measure, it would be difficult for him to draw the line on other spending measures that rely on tax increases for funding, officials said.

However, "in an ominous sign for the White House," Boehner and Blunt on Tuesday said that they might support an SCHIP bill that Bush vetoes (AP/Houston Chronicle, 10/31).

Boehner said that it is "always a possibility" that he might support a vetoed bill, while Blunt said he would "have to see the bill" before deciding (AP/San Diego Union-Tribune, 10/31).

Boehner and Blunt's comments "were the clearest sign yet that even Bush's most loyal House allies are eager for an end to the impasse," according to the AP/Chronicle (AP/Houston Chronicle, 10/31).

Funding Shortfalls

Twenty-one states will experience SCHIP funding shortfalls in the current fiscal year, and at least nine will experience shortfalls in March 2008, if Congress continues to fund the program at its current level of $5 billion for the fiscal year that began on Oct. 1, according to a study by the Congressional Research Service, the New York Times reports. States expect to spend $7.6 billion in the current fiscal year, and the program requires an additional $1.6 billion in funding to prevent the shortfalls, according to the study.

The nine states that will run out of funding in March are:

Alaska;

Georgia;

Illinois;

Iowa;

Maine;

Maryland;

Massachusetts;

New Jersey; and

Rhode Island.

The bill passed by the House last week would have provided states with $9 billion in the current fiscal year -- 80% more than current allotments -- and allotments would have more than doubled in 14 states, including Georgia, Illinois, Iowa, Maine, Massachusetts, Mississippi and North Carolina, the study found (Pear, New York Times, 10/31).

White House Tactics

The White House plans to use administrative orders to implement as much new policy as it can, after concluding that "Bush cannot do much business with the Democratic leadership," the Washington Post reports.

Recent events have "crystallized that the chances of these leaders meeting the administration halfway are becoming increasingly remote," White House spokesperson Tony Fratto said.

According to the Post, on "some issues, the White House has become increasingly left out of the legislative process." For example, Bush's insistence that an expansion of SCHIP be funded without new taxes "has pushed Republicans in the House and the Senate to pursue their own negotiations over" the expansion, according to the Post.